The Role of Food in Your Health Journey
When I first set out in search of lifestyle interventions that could change the course of my autoimmune thyroid condition, I came across a promising Italian study.
This researcher followed people who had subclinical hypothyroidism, Hashimoto’s and Celiac disease, as they embarked on starting a gluten-free diet.
The study found that when most of the people with subclinical hypothyroidism were placed on a gluten-free diet, their thyroid function normalized! In 71% of people who strictly followed a 1-year gluten withdrawal (as confirmed by intestinal mucosa recovery), there was a normalization of subclinical hypothyroidism. Another 19% of people who followed the gluten-free diet were able to normalize their thyroid antibodies. “In distinct cases, gluten withdrawal may single-handedly reverse the abnormality,” the researchers concluded.
Various studies have looked at the rates of Celiac disease in people with Hashimoto’s. All of the studies have found Celiac disease to me more common with Hashimoto’s, but the incidence rates have varied. While a 2006 Brazilian study found an incidence rate of Celiac disease at only 1.2% of people with Hashimoto’s, a 2007 Dutch study found that 15% of Dutch people with Hashimoto’s had Celiac disease.
I took these studies to my endocrinologist who reluctantly glanced over them, and told me that I shouldn’t worry about gluten, that I just needed to take Synthroid or Levoxyl and that was the end of the story to the treatment of Hashimoto’s. I was also told that my dose would continue increasing as my thyroid continued to burn itself out and that I would need to be tested for additional autoimmune disease now and then, as having one autoimmune disease put me at greater risk for having additional ones.
I ended up finding another doctor on my insurance who was willing to test me for celiac disease, but to my relief (and disappointment), I was negative. Discouraged, I didn’t attempt the gluten free diet until a little over a year later when I saw my first integrative/functional medicine doctor, who tested me for food sensitivities. Functional medicine doctors are often not covered by insurance, and it took me a long time to understand that I needed to invest in myself, that I was worth it. I paid for the consult out of pocket. It was a Christmas/New Year’s gift to myself, and the equivalent of 10 of my usual shopping trips. Giving up my shopping budget was difficult for me, as I was quite the shopping addict. Shopping kept me distracted from the feelings of sadness, fatigue, acid reflux, pain in my arms, IBS, hair loss and panic attacks. I compromised and decided to shop at second-hand stores.
The rest my friends is history. After a three-day avoidance of the reactive foods (gluten and dairy being my top triggers), my acid reflux, bloating, irritable bowel syndrome and lifelong stomach pains went away within 3 days. The pain in my arms went away after a few weeks. Figuring out that I had food sensitivities was my first step into the world of natural health- and healing- and I haven’t looked back ever since.
Since that time, I’ve learned that there’s much more than Celiac disease to the gluten-thyroid connection… a 2002 study in the journal of European Endocrinology found that 43% of people with Hashimoto’s showed activated mucosal T cell immunity, which is usually correlated with gluten-dependent enteropathy, or gluten sensitivity.
I’ve received numerous success stories from people who felt better gluten-free, and some have been able to get into remission from Hashimoto’s by going gluten free. In surveying my readers and clients, I’ve found that about 93% feel better on a gluten-free diet.
I also learned that it’s not just gluten that can be a triggering food for Hashimoto’s! The most common food sensitivities are going to be to gluten, dairy (this was my biggest one), soy, grains (especially corn), nightshades (like potatoes, tomatoes, and peppers), nuts and seeds.
Furthermore, another 75% of my clients and readers reported feeling better on a dairy free diet, 73% reported feeling better grain free, and another 60% or so said they felt better soy free. Egg and nightshade free diets were helpful 40% and 35% of the time, respectively.
Role of Food Sensitivities in Hashimoto’s
The most common triggers in Hashimoto’s are nutrient deficiencies, food sensitivities, intestinal permeability (leaky gut), stress, an impaired ability to get rid of toxins and in some cases, infections.
Food sensitivities are different than food allergies. Food allergies are generated by the IgE branch of the immune system and are going to be immediate, occurring within minutes after eating a reactive food. The person may present with anaphylaxis; hives, facial swelling, difficulty breathing; this type of reaction can be life threatening. Shellfish and nuts are the most commonly implicated foods.
Food sensitivities, on the other hand, are going to be governed by different branches of the immune system, IgA, IgM and IgG have been implicated, but the IgG branch has been the most interesting to me. This is because the IgG branch is also thought to be responsible for creating thyroid antibodies in many cases of Hashimoto’s. These reactions may take as long as hours or even a few days to manifest and may manifest as acid reflux, bloating, irritable bowel syndrome, palpitations, joint pain, anxiety, tingling or headaches.
I’ve found that recognizing and eliminating reactive foods can be a life-changer for most people with Hashimoto’s.
Reactive foods trigger an inflammatory response in the GI tract, leading to malabsorption of nutrients (gluten sensitivity, in particular, has been implicated in causing a Selenium deficiency, a well-known risk factor for Hashimoto’s), and can also produce intestinal permeability whenever they are eaten.
Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts, and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people will be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function!
Others may need to dig deeper, looking at infections, toxins, and stress, but getting off reactiveA foods almost always helps the healing process. For example, if a leaky gut is caused by a gut infection such as a parasite, to heal the gut, we not only have to get rid of the infection, but we also need to stay off the reactive foods for at least 3-6 months. Thus, I always recommend starting with food.
Testing for Food Sensitivities
When I was working as a pharmacist, we were always on the look-out for “true, IgE-related, allergies” to foods and medications. These were the life-threatening reactions that could cause anaphylaxis! While I learned about reactions mediated by the other immune branches in Immunology during my first year in pharmacy school, somehow, calling the IgE-related reactions as “true” led me to believe that the other types of reactions didn’t matter. Unfortunately, most conventional medical professionals and insurance companies hold that same misconception, and food sensitivity tests are considered “experimental.” This was, of course, fine with me, as when I “experimented” with removing the foods the tests found to be reactive for me, I felt dramatically better!
The other challenge with food sensitivities is that when we eat the foods that our body is sensitive to on a daily basis, it is very difficult to connect the foods with the symptoms we are having. For example, people who have a dairy sensitivity but continue to eat dairy multiple times a day might be tired, have joint pain, congestion, bloating and acid reflux on a daily basis, but won’t be able to pinpoint the symptom to the foods. I was personally a bread and dairy addict and had no idea that they were causing me issues.
This is because every time we eat this food, the body becomes depleted in its ability to protect itself from the antigenic food, and the reactions become less specific and more chronic. If the food continues to be given, the body will become sensitive to more and more things.
However, once the sensitizing food is eliminated for a few days to a few weeks, the person should feel better and experience less bloating, less reflux, normal bowel movements, more energy, etc.
When the person is exposed to the food again, the body will produce a stronger, more specific reaction, allowing the person to recognize which particular food is problematic to him/her. This is known as an Elimination Diet and is the gold standard for food sensitivity testing. My friend and go-to Nutritionist Tom Malterre just wrote an amazing book on the Elimination Diet, to help walk you through the process.
My Recommended Food Sensitivity Test
I thought about eliminating gluten and dairy for over a year before I took the plunge. I ate a whey protein/yogurt shake for breakfast, tuna melt bagels for lunch and loved snacking on crackers, bread, cookies, donuts, and cottage cheese at every chance I got. I was an avid baker and always attacked the bread basket at restaurants. I loved fruit but was not a big fan of meat, or vegetables.
I didn’t know how I could possibly go gluten and dairy free. Besides fruit, what was I going to eat?
It took seeing my test results in black and white to make the change, and all of a sudden, something shifted in me. I went out to an all-you-can-eat big Polish buffet with Pierogi (made from dough and farmer’s cheese), kopytka (dumplings), kotlety (breaded pork tenderloins) and a smorgasbord of cookies and cakes and said my goodbyes to the foods I had grown up with. And then I started the gluten-free dairy-free diet the next day. Acid reflux was my biggest, most noticeable symptoms that had been with me daily, multiple times a day for over 3 years, starting in January of 2008. I eliminated my reactive foods in February 2011, and I haven’t had acid reflux since that day unless I accidentally ate one my reactive foods.
Here’s my Hashimoto’s and Acid Reflux Story
My test results showed that I was sensitive to both gluten and dairy. But I wasn’t reactive to just the usual suspects, of “gluten, dairy, soy…” I also had strange reactions to pineapples, peaches and began avoiding those as well, noticing that they too, triggered my acid reflux.
There is a multitude of food sensitivity tests out there, and none of them are perfect. Some may have false negatives; others may have false positives or a combination of both.
The test that I found to be very highly accurate for myself and my clients is the Alletess Lab food sensitivity test. If a food comes up positive on that test, I know that it is a reactive food for that person. In some cases, especially if the person has been off the foods for some time, this test may have false negatives, so in the case that people come up negative for one of the big reactive foods, I recommend trying to go off it, and introducing it. Again, the gold standard, most accurate test for food sensitivities is going to be an elimination diet, but if you are someone that is not quite ready to do one, or needs to see things in black and white, you may want to look into food sensitivity testing.
Alletess Lab works primarily through integrative and functional medicine physicians, so if you’re working with a doctor like that, you can ask him/her to order the test for you. I’m also really excited to let you know that I’ve worked with MyMedLab to offer the food sensitivity testing for people to self-order, without a doctor’s prescription. The test kit comes with a little blood spot collection paper, and can be mailed to just about anywhere in the world!
MyMedLab offers two options to test for the most commonly eaten foods.
I started with the 96 food panel; it was enough to uncover most of my food triggers, and now repeat the 184 food panel on an annual basis to be sure that I’m staying on top of potential triggers, as our sensitivities and reactions to foods can change with time.
The lab will also send me trends (i.e. most reactive foods) for people with Hashimoto’s that get the tests so that I’ll be able to share this info with you in future newsletters. This way people who can afford the testing can help those that may not be able to afford it at this time.
Hope this information helps you on your journey!
PS. You can also download a free Thyroid Diet Guide, 10 Thyroid friendly recipes, and the Nutrient Depletions and Digestion chapter by signing up for my weekly newsletter. You will also receive occasional updates about new research, resources, giveaways and helpful information.
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- Hadithi, M (03/21/2007). “Coeliac disease in Dutch patients with Hashimoto’s thyroiditis and vice versa.” World journal of gastroenterology: WJG (1007-9327), 13 (11), 1715.
- Velentino, R, et.al. Markers of Potential Coeliac disease in patients with Hashimoto’s Thyroiditis. European Journal of Endocrinology (2002) 146; 479-483
- Sategna-Guidetti C, et.al. Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study. Am J Gastroenterology; 2001, Mar; 96(3):751-756